Individual provider Active NPI

Leslie Marie Cardoza, PA-C, ATC

  • Physician Assistant
  • Orange, CA
National Provider Identifier
1861841561
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
280 S Main St Ste 200
Orange, CA 92868-3852
Phone
(714) 634-4567
NPI assigned
Jun 3, 2016
Last updated
Jun 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

280 S Main St Ste 200
Orange, CA 92868-3852

Mailing address

20734 Timberline LN
Diamond Bar, CA 91789-4078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160919001312 CA Practitioner - Physician Assistant 2062709041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
May Medical Management CorporationGroup PAC ID 2668757055, 5 clinicians

Practice addresses (Care Compare)

1234 Foothill Blvd
La Verne, CA 91750-3329
Phone (909) 596-4879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53451CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Afshin Saadat MD Inc Current Accepting new patients

Locations

1234 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-4879

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1861841561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20734 TIMBERLINE LN",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917894078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST STE 200",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683852",
            "telephone_number": "714-634-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDOZA",
        "first_name": "LESLIE",
        "middle_name": "MARIE",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.